George Osborne has announced that he will add an extra £2 billion into the NHS in his Autmn Statement this week.

The chancellor said it was not a “one off” but what he called a “down payment on a long term NHS plan”. There would be no “unfunded giveaways”, he said, adding he could make the pledge because the economy was strong.

Mr Osborne’s pledge – to be officially announced in his Autumn Statement on Wednesday – comes after NHS bosses warned of a need for an extra £2 billion funding, to cope with the immediate, unprecedented pressure on NHS budgets.

The chancellor told BBC One’s Andrew Marr Show “Because we have a strong economy and we’ve got the public finances under control, we can afford to put £2 billion into the frontline of the NHS across the United Kingdom.

“I can tell you we can go further and use those fines that have been paid by the banks for a permanent improvement in GP services. This is a down-payment on the NHS’s own long-term plan and it shows you can have a strong NHS if you have a strong economy.”

Further details are expected on Wednesday when Mr Osborne will update Parliament on his tax and spending plans, based on the latest predictions for the economy.

He rejected claims public services would suffer if funding was cut further and said he would outline how the UK would “stay the course to prosperity”.

“We shouldn’t face this false choice of either bankrupting the country or having decent public services,” he said.

But he added that “difficult decisions” might lie ahead on welfare – possibly freezing working age benefits, although he appeared to rule out cuts to pensioners’ benefits.

Health Secretary Jeremy Hunt will make a statement on Monday, in which he is expected to explain where the money is coming from.

About £1.3 billion is thought to be new money, from savings in other departments, while around £700 million will come from non-NHS parts of the Department of Health’s budget.

It is understood that around £1.7 billion of that will go to NHS England, with the remainder going to the rest of the UK.
line

For months, NHS leaders have been warning politicians about a growing shortfall in their budget. Today the message from the chancellor was that he’s heard their call.

The Liberal Democrats are keen to take credit, saying they’ve fought hard to secure it. Labour say they want to go further and have pledged £2.5 billion a year to be spent on the NHS, on top of today’s announcements, paid for by a so-called mansion tax and other tax crackdowns.

NHS funding is going to be one of the key battlegrounds ahead of the next election but with figures due out this week expected to confirm that government borrowing is not coming down in line with the Treasury’s plans, all parties will face tough questions about how they can increase spending without increasing borrowing yet further.
line

Mr Hunt will also announce that the government is committed to implementing a five-year plan – NHS Forward View – unveiled by six national bodies last month. Many of the measures put forward are designed to curb the rise in hospital admissions and the impact of the ageing population.

The plans involve increasing spending on the health service by £8 billion in real terms over the next Parliament.

The NHS is a huge political issue with all the main parties pledging extra money in the future.

Hospital chiefs and cancer research leaders had been warned that funding for patients taking part in drug trials might be cut- but these were now “incorrect” according to NHS England.

Excess treatment costs (ETCs) cover the care of patients involved in drug trials which are not already covered by the pharmaceutical or academic research body involved.

Traditionally the NHS has covered these costs for patients who wish to take part in the trials.

The letter from the head of specialised commissioning at NHS England London Region, dated 21 November, was written to hospital trust medical directors and leaders in the field of cancer research.

NHS England statement

It said: “I am sure you will appreciate that in the current financial climate, the primary call for resources is to support clinical service provision for established service priorities.

“To this end, the NHS England London Region Area Team is unable to identify any uncommitted resources which could be used to support ETCs for clinical trials. This is the national position which is being adopted, in respect of all current requests for ETCs.

Cancer Research UK, which is currently supporting drug trials involving about 35,000 patients, said it had concerns.

Prof Peter Johnson, Cancer Research UK’s chief clinician, said: “The partnership between the NHS and organisations which fund research, such as Cancer Research UK, has been a great success story.”

“We lead the world in being able to offer patients participation in clinical trials, but all this will be undone if the NHS cannot keep its side of the bargain.”

A spokesman for NHS England said: “We strongly support medical research and we will fund excess treatment costs in line with the national rules, so these local letters were incorrect and are being withdrawn.”

A Department of Health spokesman said: “Research in the NHS is vital and has this government’s strong support. We have asked NHS England to set out how they will deliver their objective to promote research and ensure the payment of excess treatment costs.”

Delays in discharging patients ready to leave NHS hospitals rose to record levels last month official figures show.

Patients spent a total of 143,000 days in hospital when they should have been sent home.

In a further sign of growing pressure on the system, the number of emergency admissions also reached record levels and indicate a system under stress which is unable to free up beds because of problems arranging suitable support from care workers or district nurses.

The exact total number of “days delayed” rose to 143,118, the figure for October 2013 was 123,852.

Experts say the true situation is even worse because a lot of delays are not formally counted.

Pressures are likely to grow as winter approaches and last week there were nearly 110 emergency admissions – another record high.

Hospital bed occupancy rates are also high due to more patients being admitted and problems in discharging those who are ready to leave.

The Department of Health said there were plans in place to manage the extra demand and that planning for winter had been underway since June.

“We’ve given the NHS an extra £700 million to buy thousands more doctors, nurses and beds this winter. NHS England has ensured there are plans in every area to manage the extra demand.”

There was a slight improvement last week in the number of patients seen and treated in A&E within four hours compared with the previous seven days.

But the latest figure, 93.9%, still falls short of the official target of 95%.

Richard Murray, the director of policy at the health research group The King’s Fund said this was a particular problem for mental health services. He expressed concerns about how the NHS would cope in the coming months.

“You do wonder how much further the situation will have to go before we have a classic winter crisis,” he said.

Some 2.1bn people – about 30% of the world’s population – were overweight or obese, the researchers added.

They said measures that relied less on individual responsibility should be used to tackle the problem.

The report said there was a “steep economic toll”, and the proportion could rise to almost half of the world’s population by 2030.

The financial costs of obesity are growing – for health care and more widely in the economy. By causing illness, obesity results in working days and output lost.

The researchers argued that a range of ambitious policies needed to be considered and a systemic rather than piecemeal response was essential.

The report said the right measures could save the UK’s NHS £760 million a year

A person is considered obese if they are very overweight with a high degree of body fat.

The most common way to assess if a person is obese is to check their body mass index (BMI), which divides your weight in kilograms by your height in metres squared. If your BMI is above 25 you are overweight. A BMI of 30-40 is considered obese, while above 40 is very obese. A BMI of less than 18.5 is underweight.

“These initiatives would need to draw on interventions that rely less on individual responsibility and more on changes to the environment,” the report said.

If the right measures were taken there could be long-term savings of £760m a year for the UK’s National Health Service, it added.

The initiatives assessed in the report include portion control for some packaged food and the reformulation of fast and processed food.

It said these were more effective than taxes on high-fat and high-sugar products or public health campaigns. Weight management programmes and workplace fitness schemes were also considered.

The report concluded that “a strategy of sufficient scale is needed as obesity is now reaching crisis proportions”.

The rising prevalence of obesity was driving the increase in heart and lung disease, diabetes and lifestyle-related cancers, it said

The report was produced by McKinsey Global Institute, the business and economics research arm of consultancy firm McKinsey & Company.

Doctors’ GPs surgeries are now being ranked by the health watchdog the CQC.

The Care Quality Commission (CQC) has ranked almost every GP surgery in England in terms of risk of providing poor care and whilst the majority are of low concern, 11% have been rated in the highest risk band by the CQC.

Many of the elevated risk practices had possible issues with appointments, mental health plans, and cervical cancer screening.

The watchdog said the register did not necessarily indicate poor GP surgery performance.

“It is important to remember that the data is not a judgement, as it is only when we inspect we can determine if a practice provides safe, high-quality and compassionate care,” said CQC chief inspector of general practice Prof Steve Field.

“The data is a further tool that will help us to decide where to inspect and when,” he said.

The health watchdog ranked 7,276 practices out of the total 7,661 in England, and placed 864 practices in the “highest concern” category.

In about 3% of high-concern practices, patients stated they had difficulties in getting an appointment to see a GP or nurse.

However, surgeries that were not at high risk also saw patient dissatisfaction with appointments. In about one sixth of practices, patients had a limited ability to get appointments and services, the CQC said.

Potential issues in elevated-risk practices also included the provision of care plans for people with schizophrenia, bipolar disorder or other psychoses, and potentially low numbers of women aged 25 to 64 who had received a cervical screening test in the past five years.

The regulator used 38 different indicators to calculate the level of risk. Practices were graded in six bands, with Band One being the highest concern, and Band Six the least risky.

Measures including patient experience, care and treatment were taken into account, based on “sources including surveys and official statistics”, the CQC said.

Between April and September 2014 the CQC inspected 336 GP surgeries. At the start of October a new inspection regime came into force, and CQC hopes to have inspected all surgeries by March 2016.

The CQC will look at whether surgeries are safe, effective, caring, responsive, and well-led.